Abstract
Aim Axillary dissection is increasingly forgone in early breast cancer patients with a clinically negative axilla. The GRISO 053 randomised trial recruited 435 patients of age over 45 years, tumour ≤1.4 cm and clinically negative axilla, to assess the importance of axillary radiotherapy versus no axillary radiotherapy in patients not given axillary dissection. In the present study on a subgroup GRISO cases our aim was to assess the prognostic importance of tumour biological factors after more than 10 years of follow-up. Methods We retrospectively assessed biological factors in a subgroup of 285 GRISO cases (145 given axillary radiotherapy; 140 not given axillary radiotherapy) with complete biologic, therapeutic and follow-up information, using multivariable Cox proportional hazards regression modelling. Results Only 10-year cumulative incidence of distant metastasis was lower in the axillary radiotherapy (1%) than no axillary radiotherapy arm (7%) (p = 0.037). Irrespective of study arm, hormone receptor positivity had significantly favourable effects on 10-year disease-free survival (DFS) and overall survival. human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes were associated with lower 10-year DFS (60% and 76%, respectively) than luminal A (96%) and B (91%) (p = 0.001). Ten-year DFS for high (≥14%) Ki67 cancers was lower than for low Ki67 cancers (p = 0.027); however, this effect was mainly confined to the no axillary radiotherapy arm. Concluding statement For patients with clinically node-negative small breast cancer not given axillary dissection, 10-year DFS is worsened by HER2 positivity, triple-negative phenotype and high Ki67. Axillary radiotherapy counteracts the negative prognostic effect of high Ki67 in patients not receiving axillary dissection.
| Original language | English |
|---|---|
| Pages (from-to) | 3083-3092 |
| Number of pages | 10 |
| Journal | European Journal of Cancer |
| Volume | 49 |
| Issue number | 15 |
| DOIs | |
| Publication status | Published - Oct 2013 |
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Keywords
- Axillary dissection
- Axillary radiotherapy
- Early breast cancer
- Ki67
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
High Ki67 predicts unfavourable outcomes in early breast cancer patients with a clinically clear axilla who do not receive axillary dissection or axillary radiotherapy. / Zurrida, S.; Bagnardi, V.; Curigliano, G.; Mastropasqua, M. G.; Orecchia, R.; Disalvatore, D.; Greco, M.; Cataliotti, L.; D'Aiuto, G.; Talakhadze, N.; Goldhirsch, A.; Viale, G.
In: European Journal of Cancer, Vol. 49, No. 15, 10.2013, p. 3083-3092.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High Ki67 predicts unfavourable outcomes in early breast cancer patients with a clinically clear axilla who do not receive axillary dissection or axillary radiotherapy
AU - Zurrida, S.
AU - Bagnardi, V.
AU - Curigliano, G.
AU - Mastropasqua, M. G.
AU - Orecchia, R.
AU - Disalvatore, D.
AU - Greco, M.
AU - Cataliotti, L.
AU - D'Aiuto, G.
AU - Talakhadze, N.
AU - Goldhirsch, A.
AU - Viale, G.
PY - 2013/10
Y1 - 2013/10
N2 - Aim Axillary dissection is increasingly forgone in early breast cancer patients with a clinically negative axilla. The GRISO 053 randomised trial recruited 435 patients of age over 45 years, tumour ≤1.4 cm and clinically negative axilla, to assess the importance of axillary radiotherapy versus no axillary radiotherapy in patients not given axillary dissection. In the present study on a subgroup GRISO cases our aim was to assess the prognostic importance of tumour biological factors after more than 10 years of follow-up. Methods We retrospectively assessed biological factors in a subgroup of 285 GRISO cases (145 given axillary radiotherapy; 140 not given axillary radiotherapy) with complete biologic, therapeutic and follow-up information, using multivariable Cox proportional hazards regression modelling. Results Only 10-year cumulative incidence of distant metastasis was lower in the axillary radiotherapy (1%) than no axillary radiotherapy arm (7%) (p = 0.037). Irrespective of study arm, hormone receptor positivity had significantly favourable effects on 10-year disease-free survival (DFS) and overall survival. human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes were associated with lower 10-year DFS (60% and 76%, respectively) than luminal A (96%) and B (91%) (p = 0.001). Ten-year DFS for high (≥14%) Ki67 cancers was lower than for low Ki67 cancers (p = 0.027); however, this effect was mainly confined to the no axillary radiotherapy arm. Concluding statement For patients with clinically node-negative small breast cancer not given axillary dissection, 10-year DFS is worsened by HER2 positivity, triple-negative phenotype and high Ki67. Axillary radiotherapy counteracts the negative prognostic effect of high Ki67 in patients not receiving axillary dissection.
AB - Aim Axillary dissection is increasingly forgone in early breast cancer patients with a clinically negative axilla. The GRISO 053 randomised trial recruited 435 patients of age over 45 years, tumour ≤1.4 cm and clinically negative axilla, to assess the importance of axillary radiotherapy versus no axillary radiotherapy in patients not given axillary dissection. In the present study on a subgroup GRISO cases our aim was to assess the prognostic importance of tumour biological factors after more than 10 years of follow-up. Methods We retrospectively assessed biological factors in a subgroup of 285 GRISO cases (145 given axillary radiotherapy; 140 not given axillary radiotherapy) with complete biologic, therapeutic and follow-up information, using multivariable Cox proportional hazards regression modelling. Results Only 10-year cumulative incidence of distant metastasis was lower in the axillary radiotherapy (1%) than no axillary radiotherapy arm (7%) (p = 0.037). Irrespective of study arm, hormone receptor positivity had significantly favourable effects on 10-year disease-free survival (DFS) and overall survival. human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes were associated with lower 10-year DFS (60% and 76%, respectively) than luminal A (96%) and B (91%) (p = 0.001). Ten-year DFS for high (≥14%) Ki67 cancers was lower than for low Ki67 cancers (p = 0.027); however, this effect was mainly confined to the no axillary radiotherapy arm. Concluding statement For patients with clinically node-negative small breast cancer not given axillary dissection, 10-year DFS is worsened by HER2 positivity, triple-negative phenotype and high Ki67. Axillary radiotherapy counteracts the negative prognostic effect of high Ki67 in patients not receiving axillary dissection.
KW - Axillary dissection
KW - Axillary radiotherapy
KW - Early breast cancer
KW - Ki67
UR - http://www.scopus.com/inward/record.url?scp=84884907425&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84884907425&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2013.05.007
DO - 10.1016/j.ejca.2013.05.007
M3 - Article
C2 - 23777741
AN - SCOPUS:84884907425
VL - 49
SP - 3083
EP - 3092
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 15
ER -